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ai SENDER: I also wish to receive the <br /> 9 •Complete items 1 and/or 210raddi tonal services. following services(for an <br /> N •Complete items 3.4a.and 4b. <br /> N •Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> is Attach this form to the front of the mailpiece.or on the back it space does not 1.❑ Addressee's Address A <br /> ppeerinA' 2.❑ Restricted Deliver( <br /> w <br /> N •WAfe'RerrWillpf Rshow to won the mailpiece below the date y <br /> .t. •The Retu ipt will slaw to whom the article was delivered and the dale delivered. Consult postmaster for fed. G <br /> 0 3.Anicle A/tlressed to: 4a. rfc Numb r m <br /> u Mr Jtimes Willey �+ 6 725� 280 <br /> c <br /> o• S.S W Company 4b.Service Type 9 <br /> 0 32 S Fifth St ❑ Registered Yn Getlified me <br /> Montrose CO 81401 ❑ Express Mail ❑ Insured <br /> ❑ Return Receipt for Merchandise ❑ CO <br /> 7. Date of Delivery <br /> ZZ i <br /> 5.Received By: (Print Name) 6.Address e's Address (Only if reques d Y <br /> t and fee is paid) m <br /> c <br /> 6.Signat : (Addressee orA a t) ~ <br /> o X - <br /> '—� PS Form 1811,December 190 10259e-WS-022e Domestic Return Rec aipt <br /> P 436 785 2811 <br /> en <br /> ' US Poster Service <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> U Do not use for Intemallonal Mail See rave' <br /> games Willey <br /> Crear 8 Numfaer <br /> g� 32 S Fifth St <br /> p post Diktat s ale.a zip colie1401 <br /> ontrose CO 8 <br /> Npostage $ 27 <br /> t Certified Fee <br /> cc T� <br /> Special Delivery Fee <br /> E Restrict <br /> N <br /> Re . g <br /> ate it <br /> ro <br /> Da ee ass <br /> LOTS'e!de <br /> /�• PosMa <br /> `�'rra <br />